Photobiomodulation as an Alternative Approach for Bell's Palsy: Case Reports.

Abstract

Background: Bell's palsy (BP), also known as idiopathic facial paralysis, is an idiopathic peripheral neuropathy that unilaterally affects the facial musculature. Its management includes various therapeutic modalities, among which photobiomodulation (PBM) has shown positive effects on neuromuscular regeneration.

Objective: To describe the clinical outcomes of PBM in two patients with BP, one chronic and one acute.

Methods: The first patient, a 58-year-old woman, presented with left-sided BP of 4 years' duration and had undergone multiple unsuccessful treatments. The second patient, a 15-year-old adolescent, was diagnosed 2 weeks prior to the initiation of PBM and underwent pharmacological therapy for 2 weeks, facial physiotherapy five times per week for 5 months, and auriculotherapy once weekly for 3 months. Both patients received infrared laser therapy (808 nm, 3 J/point) following individualized, progressive protocols.

Results: In the chronic case, there was a significant reduction in orofacial pain from the first session and gradual improvement in facial mobility up to the fifteenth session, with follow-up extending to 18 months. Although complete facial symmetry was not restored, the patient reported enhanced self-confidence and quality of life. In the acute case, complete pain relief was achieved within a few sessions, and full functional recovery was observed after 14 sessions, with restoration of facial symmetry and emotional well-being. Clinical outcomes remained stable at the three-year follow-up.

Conclusions: PBM proved to be an effective tool for managing both chronic and acute BP, promoting analgesia, motor recovery, and general well-being. Its integration into multidisciplinary treatment protocols may optimize therapeutic outcomes.